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2024 Self-Insured Resolutions – Paying The Whole Tab

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2024 Self-Insured Resolutions – Workers Comp Benefits Paid From Your Budget

The 2024 Self-Insured Resolutions should start with examining the 2023 Self-Insured Resolutions.  Every year we hear from the self-insured article and newsletter readers reminding me to update last year’s resolutions.

pic goldfish 2024 self-insured resolutions
(c) Public Use License – Kim Kay

The 2023 self-insured Workers Comp resolutions can be found here.  Did you create a list and keep them?  The dynamics of self-insurance change more slowly than other types of Workers Comp insurance.  Let us look at a summary of 2023 self-insured resolutions with my comments on any 2024 changes.

  1. You are paying directly from your budget.   Nothing changed with this one for years.  No cushion exists when compared to a voluntary market policy.  Having immediate online access to your claims information remains critical. The self-insured account is always 100% funded directly out of company funds. Your organization is not “outside the worker’s comp system.”  Your company is more in it than other workers comp insureds.
  2. Those festering medical-only claims usually turn out to be the worst.  The pandemic effect is still in place.  Injured workers understandably may have not sought treatment as much as needed for minor claims.  A quick informal conversation with even the workers who sustained very minor injuries may be worth the time investment.  Check out this article on claims festering. If someone were to ask me what my biggest concern post-pandemic would be – claims festering due to non-treatment of minor claims carried over from 2021 until now.
  3. Is your company still large enough in a state to justify self-insurance?  Obtaining a voluntary market policy quote and possibly an alternative market insurance quote may be worth the effort for comparison purposes. Do not turn self-insurance into a vanity project.  
  4. Having a working relationship with your claims adjusters becomes a must from day one.  See #1 above.  With so many adjusters now working remotely, a working relationship with your TPA’s claims adjusters may take more time,  The number of an account’s claims adjusters may be more than in the past.  File assignment may not come from a central claims office.  Emailing them has been and will be the best way to contact them or provide them with claims information. The rate of adjuster turnover stayed at prior levels.
  5. Resetting your level of reinsurance can be tricky.   In prior years, I had no solid recommendation on how to calculate the level of reinsurance you may require to be a “fully covered entity.”  See the Bouns #11 suggestion below for a recommended conversation.
  6. Looking at other insurance markets.  The alternatives to self-insurance have become a cottage industry of sorts.  After the pandemic, this resolution does not seem to have changed other than the Fed Rate that we all are having to deal with through 2023. PEOs have become a very viable option since the start of 2020.  Yes, PEOs consist of returning to more of a premium structure than resembling self-insurance.
  7. Intensify the use of My Six Keys.  The keys have helped self-insureds very often over the last 20 years.  See this page for the Six Keys. You probably already know them.   The keys have not changed since the 1980s. <<That sentence made me feel old.
  8. Medical networks become more critical to self-insured success over the years.   Having an industrial-minded physician with a good bedside manner makes claims costs go down.   Remember, you are spending directly out of a budgeted account.   The next article that I am writing presently comes from a WCRI webinar on Access and Time To First Treatment.  If I were going to highlight the one number in red that costs a self-insured program the most, this would be it. 
  9. Keep your C-Level Executive or company owners updated. This resolution becomes even more important in 2024.  If you are working remotely at least part of the time, the task of updating the C-Level Executives may be neglected or delayed.  Carbon copies of certain emails can keep them updated on the program.
  10. Watch the budget for expenses (ALAE) that are not related directly to claims payments.  This is still very important.  ALAE  includes defense attorneys, medical bill processing, and medical networks to name a few providers in this category. J&L has seen sharp increases in this area in 2023.
  11. Have a conversation with the Actuary who sets your LDF (Loss Development Factor).  If you do not have an LDF calculated each year, your program is operating your budget without GPS = lost.  Many self-insureds do not question or at least discuss their LDF other than looking at the actuary’s report.

I recommend that you first look at the 2022 Self-insured resolutions.  I know those are two years old.  The 2022 resolutions are more comprehensive and a good article for reference. The 2024 self-insured resolutions do have inflation as an unspoken heavy cost variable.

For a list of resolutions for the past 15+ years, click here.

 

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James J Moore - Workers Comp Expert

Raleigh, NC, United States

About The Author...

James founded a Workers’ Compensation consulting firm, J&L Risk Management Consultants, Inc. in 1996. J&L’s mission is to reduce our clients’ Workers Compensation premiums by using time-tested techniques. J&L’s claims, premium, reserve and Experience Mod reviews have saved employers over $9.8 million in earned premiums over the last three years. J&L has saved numerous companies from bankruptcy proceedings as a result of insurance overpayments.

James has over 27 years of experience in insurance claims, audit, and underwriting, specializing in Workers’ Compensation. He has supervised, and managed the administration of Workers’ Compensation claims, and underwriting in over 45 states. His professional experience includes being the Director of Risk Management for the North Carolina School Boards Association. He created a very successful Workers’ Compensation Injury Rehabilitation Unit for school personnel.

James’s educational background, which centered on computer technology, culminated in earning a Masters of Business Administration (MBA); an Associate in Claims designation (AIC); and an Associate in Risk Management designation (ARM). He is a Chartered Financial Consultant (ChFC) and a licensed financial advisor. The NC Department of Insurance has certified him as an insurance instructor. He also possesses a Bachelors’ Degree in Actuarial Science.

LexisNexis has twice recognized his blog as one of the Top 25 Blogs on Workers’ Compensation. J&L has been listed in AM Best’s Preferred Providers Directory for Insurance Experts – Workers Compensation for over eight years. He recently won the prestigious Baucom Shine Lifetime Achievement Award for his volunteer contributions to the area of risk management and safety. James was recently named as an instructor for the prestigious Insurance Academy.

James is on the Board of Directors and Treasurer of the North Carolina Mid-State Safety Council. He has published two manuals on Workers’ Compensation and three different claims processing manuals. He has also written and has been quoted in numerous articles on reducing Workers’ Compensation costs for public and private employers. James publishes a weekly newsletter with 7,000 readers.

He currently possess press credentials and am invited to various national Workers Compensation conferences as a reporter.

James’s articles or interviews on Workers’ Compensation have appeared in the following publications or websites:

  • Risk and Insurance Management Society (RIMS)
  • Entrepreneur Magazine
  • Bloomberg Business News
  • WorkCompCentral.com
  • Claims Magazine
  • Risk & Insurance Magazine
  • Insurance Journal
  • Workers Compensation.com
  • LinkedIn, Twitter, Facebook and other social media sites
  • Various trade publications

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